Commonwealth Court Holds Relevant Prior Medical Records Must Be Provided To IME Physician

In Central Dauphin School District, et al. v. WCAB (Siler), the Claimant was successful in a Claim Petition to establish injuries including various musculoskeletal conditions including fibromyalgia. The description of injury by the WCJ also included "altered states of consciousness."

When the Employer pursued later IMEs with a neurosurgeon and psychiatrist, the psychiatrist requested pre-injury records of psychological treatment. The WCJ concluded these records were not discoverable, and the Board affirmed, reasoning the records should have been sought in the Claim Petition litigation.

The Commonwealth Court reversed. The Court noted Claimant’s Counsel did not argue that the records are not discoverable, just that they are irrelevant to the adjudicated diagnoses. The Court remanded for the WCJ to compel the discovery of records that are relevant.

Commonwealth Court Holds WCJ Has Jurisdiction Over Attorney Fee Disputes Between Counsel When Prior Counsel's Fee Has Been Approved

In K. Hendricks v. WCAB (Phoenix Pipe & Tube), the Commonwealth Court held Pitt v. Workmen’s Compensation Appeal Board (McEachin), 636 A.2d 235 (Pa. Cmwlth. 1993), petition for allowance of appeal denied, 538 Pa. 661, 648 A.2d 792 (1994) does not stand for the proposition that the WCJ does not have the authority to decide a counsel fee dispute when both attorneys’ fee petitions have been properly submitted to a WCJ.

Attorney fee disputes arise when the Claimant changes attorneys for whatever reason. Because the prior attorney is receiving a continuing 20% counsel fee, there is no room for a fee to be paid to the new attorney. The Pitt case is typically cited by WCJs to refer attorney fee disputes to the local County Bar Association Fee Dispute Committee, and ultimately to the local Court of Common Pleas. This is still the procedure if the prior attorney has not received fee approval, or at least properly placed a fee agreement in the record in an open case.

The Hendricks case states where a 20% fee has been approved for a prior attorney, the fee can be changed after an analysis by the WCJ as to what fee is appropriate for prior and present counsel. The WCJ must balance the right of the Claimant to counsel of the Claimant’s choice against the humanitarian purposes of the Workers’ Compensation Act that are perpetuated by prior counsel receiving a reasonable fee. The Court stated a Claimant cannot be permitted to avoid paying legal fees by simply discharging the Claimant’s attorney.

WCJ’s now will look at fee disputes when the Claimant changes attorneys. A WCJ still may seek consultation from the local Bar Association Fee Dispute Committee, but if there is not a resolution, the WCJ will resolve the dispute.

Claimant Cannot Petition for Modification or Reinstatement More Than Three Years After Last Date of Payment, Even When a Specific Loss is Discovered

In R. Seekford v. WCAB (R.P.M. Erectors), the Court analyzed whether the Claimant could file a claim for specific loss of his arm almost six years after the last payment of compensation via receipt of a commuted sum. The Claimant had sustained nerve damage to his arm after inadequate padding of his upper extremities during low back surgery seven and one-half years earlier. The Employer admitted an injury to the arm, but asserted the Claimant’s petition was time-barred, as it was not filed within three years of the last date of payment.

The Court held the Claimant’s Claim Petition must be treated as a Petition for Review. An injury that arose as the proximate result of surgery for the accepted injury is an injury that arose out of the accepted injury. Accordingly, the statute of limitations of three years from the last date of payment applies.

The Court then rejected the Claimant’s argument that he only discovered the specific loss when his doctor rendered an opinion of specific loss less than two years prior to the date of filing. The Court would not analogize the specific loss in this case to a specific loss of sight or hearing because the Claimant testified he knew there was a severe problem as soon as he woke up from the original surgery. The Court stated a Claimant who commutes his benefits runs the risk of finding himself beyond the statute of limitations when the Claimant’s injury worsens.

Employer Can File Termination Petition After IRE -- No Penalties for Unreasonable Contest

In J. Schachter v. WCAB (SPS Technologies), The Commonwealth Court held an award of attorney’s fees for unreasonable contest was not appropriate when the Employer filed a termination petition after an IRE and Notice of Change of Worker’s Compensation Disability Status. An IRE assessing a per cent total body impairment does not preclude a later finding of full recovery. The Employer expert’s opinion provided a reasonable basis for contest.

Commonwealth Court Holds Parties Can't Look Behind The Last Supplemental Agreement

In Sharon Tube Company v. WCAB (Buzard) the Commonwealth Court restated the principle that the parties cannot look behind the last Supplemental Agreement when requesting relief from the WCJ. The Claimant attempted to return to work, but then went off again. The Employer issued a Supplemental Agreement reinstating temporary total disability benefits. The Supplemental Agreement did not provide for a reservation of the employer’s right to file a modification petition based on the Claimant’s return to work.

The Employer later filed the modification petition. The WCJ denied the Claimant’s motion to dismiss based on the admission of total disability in the Supplemental Agreement. The WCJ found the Employer’s testimony credible and granted modification.

The Board reversed, and the Court affirmed the Board. The basis was that only the last agreement of the parties could be reviewed. Because the Employer did not produce evidence of a medical release and available work after the date of the Supplemental Agreement, no modification could be awarded.